Many people with lower extremity physical disabilities are denied access to participating in health-enhancing cardiovascular exercise because of a lack of accessible equipment. This Phase I project will design and validate lightweight, easily installed aftermarket accessory kits which convert the most popular cardiovascular exercise equipment (stationary exercise cycles) so that the machines can be used to provide beneficial exercise for persons with lower extremity mobility impairments. Primary aspects of Phase I work will be focused on design, device-user interaction (feasibility, safety), and a small pilot study evaluating the efficacy of the prototypes in improving cardiovascular fitness and upper body strength. Design criteria for Phase I seeks to create a product favorable to commercialization in which major parts are interchangeable across the three most popular brands of stationary cycles; the accessory does not affect the normal operation of the machine when the accessory is not in use; and installation of the accessory kit results in minimal change in the footprint of the machine. Upon proof of concept and successful evaluation of this Phase I project, a Phase II application will be submitted to determine applicability of the multi-use, adaptive design to other popular cardiovascular exercise equipment, including elliptical cross-trainers, steppers, and rowing machines. Phase II will also examine and evaluate the efficacy of device-specific exercise routines in reducing shoulder pain and improving health and function. This Phase I development project will provide valuable information on the design of the accessory kits for use with standard cardiovascular exercise equipment and the potential health benefits that can be attained by manual wheelchair users. [unreadable] [unreadable] [unreadable]